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Compiles and organizes medical records; distributes to Medicare Compliance nurses for analysis; and provides guidance and advice on processing claims based on nurses’ analysis. Analyzes lien notices for accuracy, communicates with the CMS to efficiently facilitate lien resolutions on claims and/or prepare MSA submissions in accordance with submission guidelines from CMS as assigned.
Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The Payroll and Benefits Specialist will assist in processing of bi-weekly and semi-monthly payroll, handling benefits enrollment and inquiries, and ensuring compliance with federal, state, and local regulations.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvote
Informs customers about CARSTAR’s repair process, including insurance claims processing, payment procedures, repair techniques, repair needs and expected delivery date of repair. 1-3 years prior experience as a collision estimator or insurance appraiser.
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This position is responsible for the following activities related to a critical system:•Experience with Healthcare Claims Processing Testing. Required Skills:•Experience on TOSCA Automated Testing Tool•Demonstrated proficiency in conducting QA and testing on EDI applications•Experience assessing the testability of requirements and developing test cases based on Business Requirements and Software Design Documents.
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Manage short- and long-term disability claims and ensure compliance with ERISA, Cafeteria Section 125, COBRA, and ACA regulations. The Payroll and Benefits Specialist will support the bi-weekly and semi-monthly payroll processing for both hourly and salaried employees, ensuring accuracy and timeliness.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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An interest in, and some exposure to, one or more of the following tools and techniques, SQL, Tableau, Alteryx, Data processing and basic statistical methods required. Experience utilizing a range of analytics involving standard data in the Pharmaceutical Industry e.g. IQVIA (MIDAS, DDD NPA, Monthly Xponent), claims data (TRUVEN, Marketscan), Epidemiological data etc.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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State government/public sector experience with health and human services programs (such as Medicaid, MMIS, claims processing, eligibility, HHS analytics, etc.) 3+ years of Medicaid, MMIS, claims process or related experience.
ExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Additionally, this resource may interface with Division Leadership and other DHHS Subject Matter Experts (SME) as required to complete the work. 3+ years of MMIS / CMS certification experience. Perform crosswalks to evaluate the State Business Process Model's (BPM) alignment with or deviation from the CMS-defined MITA BPM.
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Full time position – Remote Work - Insurance Representative requires two or more years’ experience in billing processing claims, appeals and denials. Full time position – Remote Work - Insurance Representative requires two or more years’ experience in billing processing claims, appeals and denials.
$19 - $24 an hourExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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State- specific outcome statements and KPIs must be delivered on schedule and written to ensure successful MMIS/CMS Certification, consistent with Program Management guidelines/processes and CMS expectations.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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NC DHHS is seeking IT Specialist to join the systems certification team and support the business process analysis and requirements gathering to ensure effective implementation of Technology systems supporting the Medicaid Enterprise Systems.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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You have a general understanding of healthcare topics, such as claims processing, EHRs, medical billing and coding, reimbursement models including value based arrangements, and Medicare/Medicare Advantage.
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The adjuster assists the client in fulfilling its obligation to policyholders and maintaining the client’s claims processing functions including; evaluating potential coverage issues, liability and damages, risk transfer opportunities, litigation and settlement matters within the limits of assigned authority levels and in compliance with applicable legal and regulatory requirements.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Facilitating effective and efficient processes that ensure warranty claims are managed within guidelines (to be set) for both processing and submissions. Analysis of root cause issues to identify opportunities to enhance quality whilst reducing claims.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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These functions are revenue cycle management, billing and accounts receivable, census processing, payroll, accounts payable, and patient/resident trusts. Oversee accounts receivable collections for past due patient accounts; facilitates timely filing of Medicare, Medicaid, and insurance claims.
ExpandApply NowActive JobUpdated 1 month ago
claims processing jobs in Raleigh, NC
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